[Fat Bear Science] Someone in my family has lung cancer. Will I inherit it? Seven questions about lung cancer that everyone is concerned about

Is lung cancer hereditary?

Are lung nodules lung cancer?

Can non-smokers also get lung cancer?

......

As the cancer with the highest incidence rate, lung cancer has attracted much attention.

November of each year is the global "Lung Cancer Awareness Month", and November 17 is Lung Cancer Awareness Day. We hope that everyone will pay attention to the prevention and treatment of lung cancer, raise awareness of cancer prevention and treatment, and popularize relevant knowledge about lung cancer.

Fat Bear has sorted out several issues that everyone is most concerned about. After understanding this knowledge, you will have a better idea about the prevention and treatment of lung cancer.

■

Jiang Yuequan

Director of the Thoracic Tumor Center of the Affiliated Cancer Hospital of Chongqing University, chief physician, doctor of medicine, master's supervisor, and chief expert on esophageal cancer of the Affiliated Cancer Hospital of Chongqing University.

He has been engaged in clinical and scientific research work in thoracic surgery for 30 years. He is good at thoracic surgery for esophageal cancer, lung cancer and mediastinal tumors, especially thoracoscopic and laparoscopic combined esophageal cancer radical resection, single-port lobectomy and segmental resection.

Clinic hours: Monday morning

■

Xing Huajie

Attending physician at the Thoracic Tumor Center of the Affiliated Tumor Hospital of Chongqing University, Doctor of Medicine.

He is good at the diagnosis and treatment of lung cancer, esophageal cancer, mediastinal tumors and other tumors, and is proficient in minimally invasive thoracic surgery.

What are the causative factors of lung cancer?

There are many.

At present, there is clear evidence to support that smoking is a causative factor of lung cancer. Smoking is harmful to health, mainly because smoking greatly increases the risk of lung cancer. More than 90% of lung cancer is related to smoking, and the chance of smokers getting lung cancer is dozens of times higher than that of non-smokers. In addition to direct smokers, secondhand smoke will also greatly increase the risk of lung cancer. It should be emphasized here that smoking does not necessarily lead to lung cancer, and non-smokers may also get lung cancer. Cancer is the result of the combined effects of multiple factors, but the chance of getting lung cancer is dozens of times higher.

Other possible risk factors for lung cancer include:

Air pollution, smog;

Occupational factors, such as long-term exposure to substances such as asbestos and uranium and radon (generally found in higher concentrations in basements);

In China, cooking fumes and solid fuels (such as coal briquettes, firewood, etc.) in the kitchen may also be risk factors for disease;

Other chronic lung diseases, such as tuberculosis, silicosis, pneumoconiosis, etc.;

In addition, individual factors, such as family heredity, reduced immune function, metabolic activity, endocrine dysfunction, etc., will play a certain role in the occurrence of lung tumors.

What are the manifestations and symptoms of lung cancer?

The most common symptoms of lung cancer patients are cough, shortness of breath, chest pain and/or referred back pain. In addition, depending on where the cancer grows or invades, lung cancer patients may show a variety of symptoms, and some patients may not have any symptoms. During a physical examination or when visiting a doctor for other diseases, if a mass is found in the lungs during routine examinations, further examinations should be conducted to confirm the diagnosis.

For patients with the following clinical features, especially smokers over 40 years old, appropriate examinations should be taken immediately to make a diagnosis and differential diagnosis as soon as possible:

An irritating cough with no obvious cause lasts for 2 to 3 weeks and is unresponsive to treatment.

Recently, there has been blood in the sputum or hemoptysis, which can improve on its own, but recurs repeatedly. Examination has ruled out oral or nasal bleeding.

I have been suffering from pneumonia frequently recently, and each infection occurs in the same part of the lung.

Unexplained pain in the joints of the limbs and swelling of the distal joints of the fingers and toes.

Can lung cancer be prevented?

OK.

Because the causes of lung cancer are relatively complex, there is no single drug or method that can prevent all lung cancers, but we can reduce the risk of lung cancer by staying away from known carcinogens.

Say no to tobacco

No matter how many years you have smoked or how old you are, please make up your mind to quit smoking immediately. Quitting smoking can not only reduce the incidence of lung cancer, but also provide better treatment results for lung cancer patients. After quitting smoking, the carcinogenic toxins deposited in your body will gradually decrease, and your immune function will gradually recover, your physical strength will be enhanced, and cancer and other diseases will be prevented.

Reduce the impact of environmental pollution

When the air pollution is severe, try to avoid going out and exercising, wear a mask when traveling, etc. In addition, in the living environment, such as installing a high-efficiency range hood in the kitchen, reduce the use of solid fuels, and install an air purifier.

Stay away from occupational hazards

Producers should avoid or reduce direct contact with known carcinogens, strengthen personal protection, and have regular physical examinations. Develop good living and eating habits: lead a regular life, exercise regularly, increase immunity, eat more vegetables and fruits, and eat less high-fat and high-cholesterol foods.

Develop a habit of regular physical examinations

Residents over middle age (especially 40 years and above) should have regular physical examinations. If they have symptoms such as irritating dry cough, blood in sputum, etc., they should go to the hospital for examination in time to ensure early detection and early treatment.

Can lung cancer be detected early?

OK.

Lung cancer is difficult to treat, as reflected in the high mortality rate, short survival, high drug resistance and recurrence and metastasis rates of lung cancer patients. Many early lung cancers may not have any symptoms at all, and most patients with symptoms usually have lung cancer in the middle or late stages when they seek medical treatment. Therefore, the most effective way to improve the cure rate of lung cancer and reduce the mortality rate of lung cancer is to diagnose and treat it early.

Regular low-dose CT screening can detect small nodules of 0.1 to 0.5 cm and accurately display the subtle structure and edge characteristics of small nodules in the lungs. Currently, the 10-year survival rate after surgery for early lung cancer is over 95%.

Key screening targets:

Men and women aged 40 years and above;

Those who smoke more than 20 cigarettes a day and have smoked for more than 20 years;

Those with a history of occupational exposure to harmful or toxic substances for more than 10 years;

Those with a family history of cancer;

Patients with chronic respiratory diseases and blood in sputum.

Is lung cancer hereditary and contagious?

Won't.

Many people worry that if their parents or family members get cancer, will it be inherited and contagious? Let’s talk about the first question first. There is currently no reliable evidence that lung cancer can be passed on to the next generation through genetic genes. Some lung cancers have "susceptibility genes" for lung cancer. Being born with a lung cancer susceptibility gene does not mean that a person will definitely get lung cancer, but with the superposition of other risk factors, they will be more likely to get the disease than ordinary people and the age of onset will also be younger. Therefore, if a direct relative in the family is diagnosed with lung cancer, the risk of lung cancer will increase to a certain extent. Familial clustering of lung cancer can indeed be observed clinically, but this genetic risk is not inevitable.

Regarding the second question, there is currently no evidence that lung cancer is contagious, but family members with similar living environment, eating habits, genetic background and daily routines, especially if a family member smokes, will increase the risk of lung cancer among family members, and sometimes show a family clustering of lung cancer. However, the fundamental reason for this clustering is similar risk exposure, not the existence of some transmissible pathogen.

Are lung nodules lung cancer?

uncertain.

There are many diseases that can cause lung nodules, such as pneumonia (the most common), tuberculosis, benign lung tumors and lung cancer. The specific disease causing the lung nodules needs to be checked by pathology and other examination items. The nature of the nodules can be preliminarily judged from the density of the nodules. Some solid nodules have a high probability of malignancy. The qualitative judgment of lung nodules is more complicated. If lung nodules are found during a physical examination, you must go to a specialist hospital for a clear diagnosis in time.

For the first discovery of a lung mass with a diameter of ≥3 cm, most cases require immediate development of a corresponding treatment plan, and a follow-up strategy is rarely used. Clinical specialists make a judgment based on the patient's medical history, recent physical signs, and imaging characteristics of the mass, and decide whether surgical treatment or anti-inflammatory or anti-tuberculosis treatment is needed based on the doctor's advice.

For lung nodules with a diameter of ≤1cm, since the lesions are small, the possibility and harm of malignant tumors are relatively weak. The main goal of the first visit is to confirm the diagnosis as much as possible to avoid invasive examinations for some patients with benign lesions that do not require treatment.

Most solid pulmonary nodules ≤1cm are benign and may be scars left after recovery from pneumonia, tuberculosis, or trauma. They may also be infected or non-infectious granulomas, benign tumors, etc. However, some nodules are malignant, and some benign pulmonary nodules may also become malignant.

When a lung nodule is found, the following options can generally be taken after professional doctor’s judgment:

Annual follow-up

Lung nodules of 1-3 mm are almost all benign. You don't need to worry too much about them. You just need to do a lung CT scan once a year to see if there are any changes.

Close follow-up

If solid nodules are found on CT

Low-risk group: no smoking history or other risk factors

Less than 5 mm: CT scan every 6-12 months depending on the situation

5-10 mm: CT scan every 3-6 months depending on the situation

High-risk group: history of smoking or other risk factors

Less than 5 mm: CT scan in 6-12 months

5-10 mm: CT scan in 3 months

If non-solid nodules are found on CT

Single pure ground glass nodule and single mixed density ground glass nodule

Less than 5 mm: CT scan every 6-12 months depending on the situation

5-10 mm: CT scan every 3 months depending on the situation

Multiple nonsolid nodules

Less than 5 mm: CT scan every 3-6 months depending on the situation

5-10 mm: CT scan every 3 months depending on the situation

For nodules larger than 5mm, no matter what the situation is, it is best to see an experienced thoracic surgeon, especially for nodules with an expansive growth pattern, which is more likely to be lung cancer. The thoracic surgeon will make a comprehensive judgment based on the situation and give reasonable suggestions.

Can non-smokers also get lung cancer?

Yes.

In addition to tobacco, kitchen fumes, decoration pollution, etc. can also cause lung cancer. It can be understood that if the gas people breathe in is harmful, it will cause damage to the lungs.

The pollution sources in the kitchen mainly come from harmful gases such as carbon monoxide, sulfur dioxide, carbon dioxide, and nitrogen oxides released from cooking sources such as coal gas, liquefied gas, and natural gas. In addition, cooking will also produce fumes that are harmful to health. The toxicity of kitchen fumes is directly related to the temperature of the oil when cooking. Studies have shown that when cooking oil is burned to 150°C, the glycerin in it will generate acrolein, the main component of fumes, which has a strong pungent taste and is highly irritating to the nose, eyes, and throat mucosa. Kitchen fumes also contain a carcinogen called benzopyrene, which can cause damage to the chromosomes of human cells, and long-term inhalation can induce lung tissue cancer.

Harmful gases such as radon, benzene and formaldehyde produced after house decoration are all factors that lead to a high incidence of lung cancer. In addition, long-term exposure to radioactive substances and carcinogens (such as nickel, silver, chromium, cadmium, beryllium, cobalt, asbestos, etc.) is also an important factor leading to lung cancer.

The most direct impact of air pollution on the human body is the lungs, especially PM2.5 particles, which are adsorbed in the lungs for a long time and become the cause of lung cancer.

Text/Fat Bear

Picture/partially from the Internet (please contact us to delete if there is any infringement)

Audit/Thoracic Cancer Center

Member of China Medical We-Media Alliance

Science Popularization China Co-construction Base

Chongqing Science Popularization Base/Chongqing Health Promotion Hospital

Chongqing Science and Technology Communication and Popularization Project

National Health Commission National Basic Public Health Service Health Literacy Project